The Wilson Centre, University Health Network and Temerty Faculty of Medicine, Toronto, Ontario, Canada.
College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMJ Glob Health. 2024 Nov 18;9(11):e015415. doi: 10.1136/bmjgh-2024-015415.
Disparities of power between high-income (HICs) and low- and middle-income countries (LMICs) have long characterised the structures of global health, including knowledge production and training. Historical case study analysis is an often-overlooked tool to improve our understanding of how to mitigate inequalities.
Drawing from the contemporary experience of collaborators from Canada and Ethiopia, we chose to examine the historical relationship between Ethiopian Emperor Haile Selassie and Canadian Jesuit Lucien Matte as a case study for international collaborations based on the model of an 'invited guest'. We used critical historical context and qualitative content analysis methodologies to assess written correspondence between them from the 1940s to the 1970s and drew from postcolonial theory to situate this case study in a broader context.
The respectful and responsive relationship that developed between Emperor Haile Selassie and Lucien Matte reveals important characteristics needed for meaningful collaborations in global health education. Matte came to Ethiopia fully cognizant of the imperial context of his work and prepared to take on the position of invited guest. As a result, many of both Matte and Haile Selassie's goals were achieved. At the same time, however, this case study also revealed how problematic constructions of authoritative power can arise even when productive partnerships among individuals occur. Matte and Haile Selassie's collaboration reinscribed belief in the superiority of western theories of intellectual and social development. In addition, their prescriptive vision for education in Ethiopia repeatedly dismissed competing local positions.
As international partnerships in global health education continue to exist and form, historical case studies offer valuable insights to guide such work. Among the most crucial arenas of knowledge is the need to understand powerful dynamics that have and continue to shape HIC-LMIC interaction. The historical case study of Matte and Haile Selassie reveals how problematic power differentials can be reinforced or mitigated.
高收入国家(HICs)和中低收入国家(LMICs)之间的权力差距长期以来一直是全球卫生结构的特征,包括知识生产和培训。历史案例研究分析是一种经常被忽视的工具,可以帮助我们更好地理解如何减少不平等。
借鉴加拿大和埃塞俄比亚合作研究者的当代经验,我们选择研究埃塞俄比亚皇帝海尔·塞拉西和加拿大耶稣会士吕西安·马特之间的历史关系,作为基于“受邀嘉宾”模式的国际合作的案例研究。我们使用批判性历史背景和定性内容分析方法来评估他们在 20 世纪 40 年代至 70 年代之间的书面通信,并从后殖民理论出发,将这个案例研究置于更广泛的背景中。
海尔·塞拉西皇帝和吕西安·马特之间发展起来的相互尊重和响应的关系,揭示了全球卫生教育中进行有意义合作所需的重要特征。马特完全意识到他工作的帝国背景,并准备接受受邀嘉宾的角色。因此,马特和海尔·塞拉西的许多目标都实现了。然而,与此同时,这个案例研究也揭示了即使在个人之间形成富有成效的伙伴关系时,权威权力的构建也可能存在问题。马特和海尔·塞拉西的合作重新确认了西方知识和社会发展理论的优越性。此外,他们对埃塞俄比亚教育的规定性愿景一再否定了当地的竞争立场。
随着全球卫生教育中的国际伙伴关系继续存在和形成,历史案例研究为指导此类工作提供了宝贵的见解。在最关键的知识领域中,需要了解已经并继续塑造高收入国家与中低收入国家互动的强大动力。马特和海尔·塞拉西的历史案例研究揭示了权力差距问题是如何被强化或缓解的。